Diabetes Affects Antibody Response to SARS-CoV-2 Vaccination in Older Residents of Long-term Care Facilities: Data From the GeroCovid Vax Study
Authors: Enrico Virgilio, Caterina Trevisan, Angela Abbatecola, Alba Malara, Annapina Palmieri, Giorgio Fedele, Paola Stefanelli, Pasqualina Leone, Ilaria Schiavoni, Stefania Maggi, Stefano Volpato, Raffaele Antonelli Incalzi, Graziano Onder, Angela Marie Abbatecola, Domenico Andrieri, Raffaele Antonelli Incalzi, Francesca Arenare, Viviana Bagalà, Tatjana Baldovin, Riccardo Bernardi, Alessandra Bianchi, Paola Bianchi, Raffaella Bisceglia, Ivan Bissoli, Fabio Bontempi, Gilda Borselli, Luigi Bottaro, Elisa Bottoni, Silvia Brandi, Claudio Bravin, Maria Adele Buizza, Carmine Cafariello, Alessia Maria Calabrese, Valeria Calsolaro, Marta Canepa, Carla Capasso, Mariagrazia Capuano, Sebastiano Capurso, Gabriele Carbone, Marialudovica Carducci, Silvia Carino, Nicoletta Cattaneo, Francesco Ceravolo, Maria Angelica Dorotea Chiesara, Danila Clerici, Pierpaolo Clerici, Alessandra Coin, Vieri Collacchioni, Mauro Colombo, Michela Compiano, Giuseppina Costanza, Giovanna Crupi, Roberta Cucunato, Manuela Marina D'Abramo, Emilia D'Agostino, Ferdinando D'Amico, Antonio De Simone, Stefania Del Vecchio, Maria Deleo, Annalaura Dell'Armi, Tommasina Di Brango, Anna Di Lonardo, Maria Raffaella Di Nanno, Babette Dijk, Luisa Elmo, Giorgio Fedele, Marisa Ferraro, Christian Ferro, Claudia Fiorucci, Francesca Fortunato, Pasquale Froncillo, Domenico Galasso, Nicola Galdiero, Caterina Galdiero, Stefania Gallo, Pier Paolo Gasbarri, Maria Grazia Gennai, Giuliana Ghiselli Ricci, Elisa Giribaldi, Carmen Godeanu, Samuele Gommaraschi, Roberta Granata, Giada Ida Greco, Angela Greco, Antonio Grillo, Gianbattista Guerrini, Mauro Guglielmo, Labjona Haxhiaj, Claudio Giuseppe Iacovella, Marina Indino, Valerio Alex Ippolito, David Kanah, Liudmila Kountsevich, Jovan Leci, Federica Limongi, Agata Lipari, Vincenzo Longo, Stefania Maggi, Alba Malara, Leonarda Maltese, Maria Marotta, Giuseppe Mazzarella, Hior Melnik, Pasquale Minchella, Paolo Moneti, Fabio Monzani, Walter Morandotti, Francesco Morelli, Maria Grazia Mortola, Marianna Noale, Chukwuma Okoye, Graziano Onder, Patrizia Orlanducci, Barbara Paganelli, Michele Pagano, Nicola Pagano, Raffaele Palladino, Annapina Palmieri, Magda Palumeri, Simone Paolini, Raimondo Paternò, Angela Pavan, Loris Pelucchi, Agostino Perri, Francesco Perticone, Rosanna Pesce, Sabrina Pigozzo, Francesco Pili, Rosa Prato, Rosanna Pullia, Ahmad Amedeo Qasem, Francesco Raffaele Addamo, Cecilia Raffaelli, Vincenzo Restivo, Michela Fernanda Rigon, Franco Romagnoni, Carmine Romaniello, Valentina Romano, Maria Cristina Ruberto, Marcello Russo, Bruno Sala, Sara Sambo, Maria Concetta Sciurti, Antonietta Scriva, Luca Secchi, Vincenzo Settembrini, Federica Sirianni, Deborah Spaccaferro, Fausto Spadea, Manuela Stefanelli, Paola Stefanelli, Brunella Stelitano, Stefania Stringhini, Andrea Tarsitano, Camilla Terziotti, Caterina Trevisan, Rita Ursino, Giovanni Veneziano, Maria Teresa Vigliotta, Marco Vignati, Eva Vignola, Enrico Virgilio, Maria Visconti, Stefano Volpato, Susanna Vozzi, Sabrina Zaccone
Journal: Diabetes Care (2022)

OBJECTIVE Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTCFs) and tested for differences according to antidiabetic treatment. RESEARCH DESIGN AND METHODS For this analysis, 555 older residents of LTCFs participating in the GeroCovid Vax study were included. SARS-CoV-2 trimeric S immunoglobulin G (anti-S IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2 and 6 months. The impact of diabetes on anti-S IgG levels was evaluated using linear mixed models, which included the interaction between time and presence of diabetes. A second model also considered diabetes treatment: no insulin therapy (including dietary only or use of oral antidiabetic agents) and insulin therapy (alone or in combination with oral antidiabetic agents). RESULTS The mean age of the sample was 82.1 years, 68.1% were women, and 25.2% had diabetes. In linear mixed models, presence of diabetes was associated with lower anti-S IgG levels at 2 (β = −0.20; 95% CI −0.34, −0.06) and 6 months (β = −0.22; 95% CI −0.37, −0.07) after the first vaccine dose. Compared with those without diabetes, residents with diabetes not using insulin had lower IgG levels at 2- and 6-month assessments (β = −0.24; 95% CI −0.43, −0.05 and β = −0.30; 95% CI −0.50, −0.10, respectively), whereas no differences were observed for those using insulin. CONCLUSIONS Older residents of LTCFs with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish humoral immunity similar to that in individuals without diabetes.